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Oregon rates for HCPCS Q0161

Chlorpromazine Hydrochloride 5 Mg Oral Fda Approved Prescription Anti-Emetic For Use As A Complete Therapeutic Substitute For An Iv Anti- Emetic At The Time Of Chemotherapy Treatment Not To Exceed A 48 Hour Dosage Regimen (Code Deleted 01/01/02 Reinstated 01/01/14) Factor Ix (Antihemophilic Factor Recombinant) Peri.U.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.33 / $0.78 / $0.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.31 / $0.32 / $0.36
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.72 / $0.72 / $0.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.33 / $0.33 / $0.33
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$170.00 / $170.00 / $178.00
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.32 / $0.39 / $0.69
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$79,999.20 / $79,999.20 / $79,999.20
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.32 / $0.39 / $0.69
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.33 / $0.44 / $0.51
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.23 / $2.23 / $2.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.33 / $0.33 / $0.38